Karasneh J, Christoforou J, Walker JS, Dios PD, Lockhart PB, Patton LL. World Workshop on Oral Medicine VII: Bleeding control interventions for invasive dental procedures in patients with inherited functional platelet disorders: A systematic review.
Oral Surg Oral Med Oral Pathol Oral Radiol 2021;
133:412-431. [PMID:
34758941 DOI:
10.1016/j.oooo.2021.08.003]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVES
The objective of this study was to determine bleeding control interventions (BCIs) that were reported to be effective in controlling postoperative bleeding in patients with inherited functional platelet disorders (IFPDs) undergoing invasive dental procedures.
STUDY DESIGN
We searched MEDLINE/PubMed, Embase, Cochrane Library (Wiley), and Scopus from 1960 through April 2020 for studies on patients with IFPD undergoing invasive dental procedures. Two reviewers conducted assessments independently.
RESULTS
We found a total of 620 nonduplicate published articles, of which 32 studies met our inclusion criteria. Management with BCI in patients with IFPD included in this systematic review was effective in 80.7% of treatment sessions. Local measures used intraoperatively were found to be effective. Three different protocols of BCI were noted; the most effective protocol consisted of antifibrinolytics, scaffold/matrix agents, and sutures (P < .01). An adjunct protocol consisting of a tissue sealant was also effective (P < .01). A third protocol of platelet transfusion and antifibrinolytics was ineffective in controlling postoperative bleeding in 4 of 6 dental sessions.
CONCLUSIONS
This systematic review supports the use of local measures intraoperatively and antifibrinolytics postoperatively. It also supports making decision regarding platelet transfusion based on the clinician's clinical judgment and medical history of the individual patient.
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